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Individual

SISIRA KUMARA ANDRAHENNADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
3500 N BROAD ST RM 1A, PHILADELPHIA, PA 19140-4106
(215) 707-3411

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
33960
OK
207L00000X
Anesthesiology Physician
C1-0006402
DE
207L00000X
Anesthesiology Physician
Primary
MD071641L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001811218
PA
05
1093791147
DE
05
8856702
NJ
01
P00691982
RAILROAD MEDICARE
PA
01
P00918738
RAILROAD MEDICARE
DE
Enumeration date
12/21/2005
Last updated
04/02/2025
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